Investigators have found that men with osteoarthritis may be nearly four times more likely to experience erectile dysfunction than those without osteoarthritis.
In the study, published in Sexual Medicine, the investigators aimed to explore the associations between erectile dysfunction and two prevalent types of arthritis: osteoarthritis and rheumatoid arthritis. They used data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2004.
Utilizing a cross-sectional design, the investigators employed a stratified multistage random sampling methodology to ensure a nationally representative sample. The patients with incomplete erectile dysfunction or arthritis data and those with a history of prostate cancer were excluded from the study to maintain data integrity. Erectile dysfunction was assessed through a single-question self assessment, categorizing responses of “sometimes able” or “never able” as having erectile dysfunction. A diagnosis of osteoarthritis and rheumatoid arthritis was based on self-reported information during personal interviews.
The primary outcome was the self-reported incidence of arthritis. The investigators included 3,370 patients with an overall osteoarthritis incidence of 7.3%. The prevalence of erectile dysfunction was significantly higher in patients with osteoarthritis (16.5%) compared with those without osteoarthritis (4.38%). Similarly, among the 3,305 participants analyzed for rheumatoid arthritis, the prevalence of erectile dysfunction was 11.1%, markedly higher than the 3.82% observed in the patients without rheumatoid arthritis.
Multivariable logistic regression analyses were then performed to determine the associations between erectile dysfunction and both types of arthritis. Three models were used: Model 1, with no adjustments; Model 2, adjusted for age and race; and Model 3, adjusted for additional covariates like education, poverty-to-income ratio, marital status, body mass index, C-reactive protein levels, hypertension, diabetes, smoking status, and physical activity. The association between erectile dysfunction and osteoarthritis remained significant in Model 3 (odds ratio [OR] = 2.13, 95% confidence interval [CI] = 1.4–3.09). For rheumatoid arthritis, Model 3 demonstrated a robust positive correlation (adjusted OR = 1.6, 95% CI = 1.0–2.5).
The investigators noted that there may have been a closer connection between osteoarthritis and erectile dysfunction than between rheumatoid arthritis and erectile dysfunction. As a systemic immune disease, rheumatoid arthritis often affects not only the bones, joints, and soft tissues; but also targets cardiovascular, respiratory, and neurologic health—leading to complex comorbidities.
However, for osteoarthritis, “the intricate association between these two conditions [osteoarthritis and erectile dysfunction] is likely influenced by underlying mechanisms that warrant further exploration. While the exact nature of this relationship is yet to be fully unraveled, shared pathophysiological factors may play a pivotal role,” the study authors underscored.
The investigators emphasized the importance of interdisciplinary collaboration among urologists, rheumatologists, and other specialists to comprehensively address the interconnected health concerns of patients.
The study authors reported no conflicts of interest.
